In-Network
Insurance Carriers
An integral part of providing exceptional care and genuine compassion is to ensure that our patients are able to afford the care they need or want. Our team is proud to participate with a long list of insurance carriers to make treatment financially feasible for you. It is our goal to maximize your insurance benefits, so let's take a look at how we can work with you and your insurance carrier to take the worry out of planning financially for your care.
Aetna
Aflac
Ameritas
Cigna
Delta Dental
Dentemax
DHA / Sunlife
Guardian
Humana
Metlife
Optum
United Concordia
Terms Defined
Benefit Maximum
The maximum dollar amount that your dental insurance will pay toward the cost of covered dental services and or treatment in a benefit plan year, typically a 12-month period.
The maximum dollar amount that your dental insurance will pay toward the cost of covered dental services and or treatment in a benefit plan year, typically a 12-month period.
The dollar amount that you must pay for covered dental services before your dental plan start to pay.
A paper of electronic statement provided by your dental insurance company, which breaks down any dental treatments or services that you have received, this is different from a bill.
When a treatment plan is submitted to the insurance company before treatment begins. The insurance company reviews the plan and provides an estimated dollar amount for the out-of-pocket portion of the proposed treatment.
A roadmap for a patient's dental health, that outlines the recommended treatment plan provided by the doctor for the patient's desired treatment outcome.
Terms Defined
Commonly Asked Insurance Questions
Generally, no. Our admin team cannot provide treatment estimates over the phone for a couple of really important reasons we've listed below for your consideration. In some cases, our team may be able to provide a very broad 'ballpark' figure, but those will all be given as fully out-of-pocket costs without your specific insurance factored in. The only way to receive a treatment plan estimate for your case, with your insurance factored in, is to complete a consultation with a surgeon.
Why Our Admin Team Can't Provide Treatment Estimates Over the Phone
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Admin members cannot diagnose and/ or confirm a diagnosis
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Admin members cannot assess medical history and/ or need of a patient
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Admin members cannot discuss treatment options outside of that which is listed on a referral, and can only be discussed within the circumstances of our patient care guidelines at New Albany Oral and Facial Surgery
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Admin members cannot complete an insurance verification benefit review until an appointment is scheduled
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After you schedule your consultation appointment, our in-house Insurance Verification team will get to work contacting the insurance companies you provided at the time of scheduling to verify your benefits. Our team requests the following information from your insurer to ensure we have current and correct information regarding your policy so that we are able to provide you with advance notice of any out-of-pocket charges you may incur during any stage of your care with our office.
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Eligibility
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Benefit Period + Policy Maximums
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Policy Deductible
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Coverage Percentages for Preventative Services like Consultations and Imaging
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Coverage Percentages for the Most Common Oral Surgery Surgical Codes
like Extractions and Dental Implants
If our Insurance Verification team is unable to verify your benefits ahead of your appointment, our team will contact you to verify the information we have on file for you.
If our Insurance Verification team finds that you have met your eligibility allowances for your benefit maximum, exam or imaging frequency, or has found that you do not have coverage for an anticipated code, our Administrative team will contact you to advise of this information and provide you with out-of-pocket estimates. If you are expected to owe anything out-of-pocket at your visit, you are always offered the opportunity to reschedule your appointment without penalty (see Cancellation Policy) if you are unable to pay the anticipated amount owed on the day of your appointment.-
No. If you prefer to pay out-of-pocket, we are not required to file claims to your dental insurance.
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If our office is out-of-network with your insurance carrier, we will very likely be aware of this at the time of scheduling or when we verify your insurance policy ahead of your arrival. If you are out-of-network, our team will notify you in advance of your appointment to advise you of what you would be expected to owe out-of-pocket. If you are not comfortable with proceeding with your appointment out-of-pocket, you may reschedule without concern for incurring any broken appointment charge as outlined in our cancellation policy.
If you proceed with care in our office as an out-of-network patient, we will provide you with the necessary paperwork to file for reimbursement from your insurance. Some carriers will reimburse for out-of-network care, some will not. We recommend checking with your insurance carrier prior to deciding whether or not to proceed as an out-of-network patient.
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Commonly Asked Insurance Questions
1
Can I get an estimate over the phone before I decide to schedule a consultation?
Generally, no. Our Scheduling Specialists cannot provide treatment estimates over the phone for a couple of really important reasons we've listed below for your consideration. In some cases, our team may be able to provide a very broad 'ballpark' figure, but those will all be given as fully out-of-pocket costs without your specific insurance factored in. The only way to receive a treatment plan estimate for your case, with your insurance factored in, is to complete a consultation with a surgeon.
Why Our Scheduling Specialists Can't Provide Treatment Estimates Over the Phone
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Scheduling Specialists cannot diagnose and/ or confirm a diagnosis
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Scheduling Specialists cannot assess medical history and/ or need of a patient
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Scheduling Specialists cannot discuss treatment options outside of that which is listed on a referral, and can only be discussed within the circumstances of our patient care guidelines at Charleston Oral and Facial Surgery
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Scheduling Specialists cannot complete an insurance verification benefit review until an appointment is scheduled
2
Will my insurance cover the consultation? How will I know if I'm going to owe anything out-of-pocket?
After you schedule your consultation appointment, our in-house Insurance Verification team will get to work contacting the insurance companies you provided at the time of scheduling to verify your benefits. Our team requests the following information from your insurer to ensure we have current and correct information regarding your policy so that we are able to provide you with advance notice of any out-of-pocket charges you may incur during any stage of your care with our office. Eligibility Benefit Period + Policy Maximums Policy Deductible Coverage Percentages for Preventative Services like Consultations and Imaging Coverage Percentages for the Most Common Oral Surgery Surgical Codes like Extractions and Dental Implants If our Insurance Verification team is unable to verify your benefits ahead of your appointment, our team will contact you to verify the information we have on file for you. If our Insurance Verification team finds that you have met your eligibility allowances for your benefit maximum, exam or imaging frequency, or has found that you do not have coverage for an anticipated code, our Administrative team will contact you to advise of this information and provide you with out-of-pocket estimates. If you are expected to owe anything out-of-pocket at your visit, you are always offered the opportunity to reschedule your appointment without penalty (see Cancellation Policy) if you are unable to pay the anticipated amount owed on the day of your appointment.
3
Do I have to use my dental insurance?
No. If you prefer to pay out-of-pocket, we are not required to file claims to your dental insurance.
4
What if you are out of network with my insurance
If our office or providers are out-of-network with your insurance carrier, we will very likely be aware of this at the time of scheduling or when we verify your insurance policy ahead of your arrival. If you are out-of-network, our team will notify you in advance of your appointment to advise you of what you would be expected to owe out-of-pocket. If you are not comfortable with proceeding with your appointment out-of-pocket, you may reschedule without concern for incurring any broken appointment charge as outlined in our cancellation policy. If you proceed with care in our office as an out-of-network patient, we will provide you with the necessary paperwork to file for reimbursement from your insurance. Some carriers will reimburse for out-of-network care, some will not. We recommend checking with your insurance carrier prior to deciding whether or not to proceed as an out-of-network patient. Eligibility Benefit Period + Policy Maximums Policy Deductible Coverage Percentages for Preventative Services like Consultations and Imaging Coverage Percentages for the Most Common Oral Surgery Surgical Codes like Extractions and Dental Implants If our Insurance Verification team is unable to verify your benefits ahead of your appointment, our team will contact you to verify the information we have on file for you. If our Insurance Verification team finds that you have met your eligibility allowances for your benefit maximum, exam or imaging frequency, or has found that you do not have coverage for an anticipated code, our Administrative team will contact you to advise of this information and provide you with out-of-pocket estimates. If you are expected to owe anything out-of-pocket at your visit, you are always offered the opportunity to reschedule your appointment without penalty (see Cancellation Policy) if you are unable to pay the anticipated amount owed on the day of your appointment.